Medicine will never be the same after the electroshock of the Covid-19, which has notably accelerated the development of a panoply of technologies and forced important awareness.
Revolution
Grand
Dossier
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Illustration: Nathalie Samson
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If there is one lesson that the health system will have learned, it is the importance of not depending on other countries for supplies of gowns, gloves and other medical equipment.
States will no doubt make sure they are ready for a next pandemic, a bit like the armies which are always ready for war, illustrates Benoît Mâsse, professor at the School of Public Health at the University of Montreal.
Moreover, Dr. Gilbert Boucher notices that most of the masks he now uses are made in Quebec.
“And they are excellent masks.”
“We realize that we cannot do everything in China,” explains André-Pierre Contandriopoulos, professor at the School of Public Health at the University of Montreal. It’s a bit like agriculture: there are things we can do at home, even if it costs a little more. “
Medicine is undergoing a revolution thanks to artificial intelligence and all the technological innovations precipitated by the pandemic, believes Dr. Karl Weiss, specialist in infectious diseases at the Jewish General Hospital in Montreal.
For example, microbiological tests now allow instant detection and can be performed just about anywhere and by anyone, says Karl Weiss.
Remote monitoring devices can diagnose ear infections or record data from the chest of a patient who is at home, he adds.
In addition, the accumulation of data will make it possible to better follow the clinical trajectory of patients. Thus, when a 40-year-old woman with chest pain calls Info Santé, we will be able to tell her that the probability of a heart attack is very low because we will know that out of the thousands of people with the same profile and the same symptoms, only one was hospitalized.
“We are moving towards a transformed medicine”, summarizes Karl Weiss.
Why travel in person for a booze that can be the subject of a remote consultation? Many clinics went virtual during the pandemic, and many patients obtained a prescription or medical advice with a simple phone call or video call. Telemedicine is therefore here to stay, the experts interviewed are convinced.
“It will allow us to optimize the way we practice medicine,” believes Dr. Judy Morris, president of the Association des médecins d’Urgence du Québec.
In some places, telemedicine will allow people to avoid having to drive two hours or pay for parking, illustrious Mylaine Breton, professor at the Faculty of Medicine at the University of Sherbrooke.
Its use could even be broadened to facilitate access to mental health care in regions where there is a lack of interveners, she suggests.
But in all cases, it will be necessary to find the right dosage of telemedicine since certain health problems cannot be evaluated remotely, remind the experts.
The development of messenger RNA technology, used in vaccines from Pfizer and Moderna, has been accelerated “exponentially” and could be used to treat a variety of other diseases, notes Alain Lamarre, immunovirologist at the National Institute. of scientific research.
For example, this technology could make it possible to create personalized treatments in oncology, such as “encoding messenger RNA so that our system develops an immune response to our own cancer”, illustrates Mr. Lamarre.
There was a time when a person with a cold and obviously contagious could show up in a 5-7 without anyone blinking. Experts believe that those days are over, the pandemic having brought about a culture change. “It is over, that era. This is no longer acceptable, ”summarizes Dr Gilbert Boucher. “We are going to keep a little embarrassment before going in a non-essential activity with a little fever and cough, saying to ourselves that ‘it’s not so bad’,” says Dr. Caroline Quach. “And if the activity is essential, well, we wear the mask,” she adds.
Illustration: Nathalie Samson
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If Quebec succeeded in avoiding the catastrophe of a drug shortage at the heart of the first wave, it is thanks to a new storage method that will continue to be used in the future.
Before, health professionals stored few drugs to prevent unused doses from expiring and therefore wasted.
It was the just in time method, sums up François Paradis, president of the Association of Pharmacists of Quebec Health Establishments.
Health establishments now keep an inventory that corresponds to 90, 60 or 30 days of their usual consumption, depending on the type, explains Jean-François Bussières, former president of the pharmacists committee of the Government Acquisitions Center.
“One thing is certain, we will not go back to the just in time method,” concludes Mr. Paradis.
– With Clara Loiseau
Illustration: Nathalie Samson
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The mask will still be visible in the landscape when the pandemic has subsided, much like what was already done in Asia before, experts believe.
People will probably tend to wear it in public when they have symptoms of a cold or on public transport, for example.
Those who make this choice “will no longer be looked down upon,” says Dr. Caroline Quach, head of infection control at CHU Sainte-Justine.
“We can imagine Public Health calling on the population to wear it” at times, supposes André-Pierre Contandriopoulos, professor at the School of Public Health at the University of Montreal.
In clinics and hospitals, the mask could continue to be used to prevent respiratory infections other than Covid-19, believes Dr. Judy Morris, of the Quebec Association of Emergency Physicians.
Illustration: Nathalie Samson
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“I don’t think there is anyone who thinks infectious disease doesn’t matter anymore,” says Dr. Karl Weiss.
If a new pandemic were to strike in 10 or 15 years, laboratories as well as public health authorities will be better prepared to react to it, believe several experts.
“Before, there were people who had to fight to remember the importance of infection prevention,” says Dr. Caroline Quach.
In addition, we can expect a return to the “heyday” of public health, an area that has been gradually defined in Quebec in recent years, recalls Benoît Mâsse of the School of Public Health of the University. from Montreal.
“A new emergency is a single room with doors that close,” says Dr. Gilbert Boucher, president of the Association of Quebec Emergency Medicine Specialists.
Thus, we will see fewer and fewer rooms crowded with patients separated by curtains, he predicts.
In most emergencies, ventilation systems have been installed, the isolation and partitioning of rooms have been improved, he adds.
“It will stay and it’s very good.”
In general, there is a change in mentality which means that the level of protection of patients has really increased, observes the doctor.
For example, hospitals now offer washing of uniforms. We therefore see fewer nurses and attendants walking around in work clothes in the street, notes Dr. Boucher.
Illustration: Nathalie Samson
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Adults are likely to have to roll up their sleeves regularly to be inoculated against Covid-19, much like seasonal flu did, some experts suspect.
Benoît Mâsse, professor of public health, paints the hypothetical image of vaccination campaigns that would take place once a year or every two years for people to go and get their booster.
“Or maybe it will just be a part of the population that will be vaccinated periodically, such as 50 years or 70 years and over”, abounds the immunovirologist Alain Lamarre.
Of course, that will depend on how the virus and its variants evolve, experts qualify.
Several experts believe that we will not soon forget how precious the work of the “guardian angels” is, even if we manage to overcome the shortage of personnel one day.
The pandemic will have forced us to review the importance of providing pleasant conditions for our health professionals, explains Mylaine Breton, professor at the University of Sherbrooke.
“It is a project for the next 10 years.”
The Covid-19 revealed how faulty the health care system was, even if it had been for decades, abounds André-Pierre Contandriopoulos, of the School of Public Health at the University of Montreal. Nothing is certain, but the pandemic could act like an “electric shock” finally forcing the leaders to a positive and profound change of the system, he hopes.
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